Palejovo ABC - DIAGNOSIS

Everyone reacts to a child's diagnosis in a slightly different way, and also goes through the process of accepting it at their own pace. And while we can distinguish several phases of characteristic reactions to diagnosis and illness, this does not mean that every person will go through them all. Some may be prolonged, others may not appear at all.

The reaction depends on many factors - previous experiences, prognosis, how surprising the diagnosis was, an optimistic or pessimistic approach to problems, the way we think (whether we focus more on dwelling on the past or thinking about the future), the support we receive from others, our mood and health, temperament... What is certain, however, is that each person reacts as best he or she can in a given situation and tries his or her best to cope with the diagnosis.

In treating her patients, Elisabeth Kübler-Ross observed that the phases of coping are denial, anger, bargaining, depression and acceptance. We can also relate these stages to coping with a child's diagnosis.

How do they proceed?

1. denial - Receiving a diagnosis may be accompanied by shock. It involves a sense of confusion, helplessness and unreality of the situation. This is usually such a stressful moment that parents in the initial stage may deny the information received. It can't be true, it's just a bad dream, it's definitely a mistake - such thoughts and words are typical during this initial period. The attempt to deny the situation and the lack of belief in what is happening are defense mechanisms that try to protect us from difficult emotions and maintain balance. During this period, it can also happen that we do not remember what happened, what the doctor said, what recommendations he gave. Remaining in this phase for a long time can make it difficult to build a bond with the child and respond adequately to his needs (both emotional and physical). There may be difficulty in adjusting one's requirements to the child's abilities and treating him as fully healthy. At the same time, the willingness to make efforts aimed at improving the child's condition may decrease.

2 Anger - Parents may experience feelings of injustice and anger. They wonder: why exactly is this happening to me, why is this happening to my child? Caregivers realize the seriousness of the situation, they allow themselves the thought of the child's diagnosis, but cannot accept it. Blaming can occur - both of themselves (e.g., I could have taken better care of myself during pregnancy) and of others (e.g., it's all because of the doctors, how could they not notice that something is wrong, it's because of my parents, they could have stayed out of our lives and not upset us). Aggressive and impulsive behavior can happen - smashing objects, throwing them, slamming doors. This anger covers up the tremendous anxiety, grief and disappointment that smolders beneath the surface.

3 Bargaining and negotiation - this is the period when there is a belief that there is a possibility of a smooth and effective recovery. The family begins to fight for the child's health. It is interested in treatment, becomes familiar with the disease. At this level, the pragmatic mind works. However, magical thinking can also come into play, which can lead to the use of unproven and sometimes even harmful methods and meeting with various types of healers who promise an effective cure for the child. Also characteristic of this stage are all sorts of thoughts and promises that we sacrifice, so to speak, just to succeed in curing the child: I can give up my health just so that my child will be cured. Maybe I didn't pray enough, I will pray more, just please let it get better. I will never raise my voice against my child again, just please let him get better.

The active search for new and effective methods of action can lead to fatigue not only for parents, but also for the child. Undertaking many activities, different types of therapies - sometimes mutually exclusive - is obviously intended to help the child, but sometimes it has the opposite effect. There is a risk that the child will be overburdened by what is offered and, instead of making progress, will stagnate or even regress in behavior or development. At this stage, there is a lot of emotional cost to the whole family, which can lead to burnout and depression.

4 Depression - usually this period is one of the longest. It is accompanied by a sense of helplessness and hopelessness. Everything is pointless, nothing will help anyway. It will always be so hopeless. I'm afraid that the next treatment will fail. I won't be able to cope.

The family descends into sadness, and earlier hope is replaced by helplessness. Parents are aware of the impact of the disease on their child's life and functioning. They begin to realize the limitations that the disease will bring not only to the child, but also to the entire family. They worry about the economic situation and wonder how to organize funds for life and treatment. One parent often quits his or her job because caring for the child becomes too absorbing and demanding. The child's progress ceases to please, and fatigue becomes nagging and overwhelming. Conflicts can arise between partners, especially when they have different ways of responding to difficult situations. Misunderstanding, withdrawal, feelings of loneliness and resentment towards the other person appear. On top of all this, there is sometimes shame related to the child's illness and blaming themselves and others. The family at this stage needs support, looking in one direction, striving together for a goal, which sometimes proves to be beyond their strength and capabilities. That's when it's worth reaching out for outside help.

5 Acceptance - I am reconciled to the fact that it is as it is. I do what I can and what I can influence, and accept the rest. At this stage, there is a final farewell to expectations and the vision of a fully healthy child. There is greater gentleness in family members for each other and the child. The family again begins to enjoy the child's progress and new treatment options. Family members become accustomed to the situation and become involved in the treatment process.

It is worth remembering that everyone deals with their pain differently. One day you may be in despair, and another day you may feel that you can do anything. Emotions can change like in a kaleidoscope. Each is valid, and each will eventually pass. During the period of coping with the diagnosis, it is worth being gentle with yourself and giving yourself the time you need.